Agent Nomination Form

Please note to process your application your passport MUST have a Holder's Signature matching your nomination form signature.

- कृपया अंग्रेजी में जानकारी दर्ज करें

यदि आपकी उम्र 18 वर्ष से कम है, तो यह आवश्यक है कि यह फॉर्म आपके माता-पिता द्वारा भरा जाए।

Form #172

Complete all sections of this form and provide the necessary signatures. Submit the completed form.

Personal Information

Title

Miss.

Mr.

Mrs.

Ms.

Mx.

Other

Given Names

Middle Name (if Applicable)

Family Name

Country of Passport

Phone Number

Accompanying members of the family unit Passport Details

Family name:

Given names:

Sex:

Date of birth:

Country of birth:

Passport number:

Country of passport:

Is the above information correct?

Applicant(s) Home Address

Full Address

Postcode

City

Country

Genuine Temporary Entrant (GTE) and Genuine Student

Genuine Student (GS) Declarations

✅ Acknowledgment & Accuracy
I confirm that I have read, understood, and accept all statements and conditions outlined in this document. *
I declare that all information provided is true, complete, and accurate to the best of my knowledge. *

✅ Genuine Temporary Entrant & Student Commitment
I understand that I must be a Genuine Temporary Entrant (GTE) and a Genuine Student (GS) for the purpose of studying in Australia and applying for a student visa. My primary purpose in Australia is to study, and I intend to complete my course within the expected duration.

✅ Course Selection & Alignment
I confirm that I have reviewed and understood all course details, including:

Entry requirements
Tuition fees
Campus location
Course duration
Career opportunities

The selected course aligns with my career aspirations, previous education, and work experience, enhancing my skills and knowledge in my field.

✅ Education & Employment History
I have provided accurate details of my education and employment history, ensuring that there are no unexplained gaps. My work experience is relevant to my course and will benefit from the additional qualifications I will gain.

✅ Future Plans
I have outlined my post-study plans, including how I will apply my acquired skills and knowledge in my home country or another country. I intend to return upon completing my studies.

✅ Study Destination Choice
I have justified my decision to study in Australia over other countries based on:

The quality of education
The reputation of the institution
Opportunities for personal and professional growth

✅ Financial Capability
I confirm that I have sufficient and legitimate funds to cover:

Tuition fees
Living expenses (for myself and any dependents)
Ancillary costs throughout my entire study duration

I have provided valid evidence of these funds, ensuring they meet the financial requirements.

✅ English Language Proficiency
I meet the English language requirements for my course and have provided recognized test results (IELTS, TOEFL, or equivalent).

✅ Visa History & Dependents
I have truthfully disclosed all previous visa applications and their outcomes, including any refusals or cancellations.
I have declared whether my spouse and/or dependents will accompany me and understand the financial and visa requirements for their support.

✅ Health, Character & Visa Compliance
I confirm that I:

Meet the health and character requirements for an Australian student visa
Will provide necessary health examinations and police certificates if required
Will maintain satisfactory academic progress and attendance as per visa conditions
Will comply with all student visa requirements, including work restrictions

✅ Financial Declaration & Australian Values Commitment
I/We declare that I/we have secured and provided evidence of sufficient financial resources to cover:

Travel, tuition, and living expenses for the first 12 months
Additional funds for the full study duration
Schooling costs for any accompanying school-aged dependents

I/We confirm that I/we have read or been informed about Australian society and values and agree to uphold and abide by the principles outlined in the Australian Values Statement and Life in Australia booklet.

Genuine Student (GS) Declarations

Yes

AGENT DETAILS

AGENT DETAILSAgency Name:

Agent (TPXXXXX) Code , enter N/A if not available

Agency location/city:

Contact person:

Email address:

Phone no:

Agent Authorization and Disclaimer

Agent Authorization

✅ Authorization & Representation
I authorize the appointed agent to act on my behalf for this application, including submitting documents and making inquiries. *

✅ Information Release & Consent
I agree to the release of information related to my application, visa, and admission to the agent, education provider, and relevant authorities. *
I consent to the collection, use, and disclosure of my personal information as outlined in the education provider's privacy statement. *

✅ Privacy & Data Protection
I confirm that I have read, understood, and accepted the privacy statement and its terms. *
I understand my right to access and request corrections to my personal information. *

✅ Legal & Compliance Acknowledgment
I acknowledge my legal obligations as an international student in Australia. *
I understand that providing false or misleading information may result in application rejection or withdrawal of an offer. *
I acknowledge that the education provider reserves the right to reverse decisions if incorrect information is discovered. *

Agent Authorization

Yes

Intended Course(s) of Study in Australia

What is the name of the Course(s) you want to study in Australia?

What is your budget for the entire duration of your course? Round up the amount please.

Genuine Student (GS) requirement for a student visa to Australia

All student visa applicants are required to provide information in support of their application to demonstrate that they meet the Genuine Student criteria.
Provide responses to support the applicant's ability to meet the criteria and ensure supporting documents are attached.

Explain how completing the course will be of benefit to the applicant.

Explain why the applicant wishes to study this course in Australia with this particular education provider including their understanding of the requirements of the intended course and studying and living in Australia.

Give details of the applicant's current circumstances, including ties to family, community, employment and economic circumstances.

Give details of any other relevant information the applicant would like to include.

Emergency Contact

Title

Given Names

Family Name

Please Describe Relationship to the Student

Telephone

Full Address

Upload Passport Scan (Required)

When applying for any formal document or entering into an official process, consistency in your personal details is crucial. One such detail that often goes overlooked is the signature. It may come as a surprise, but your passport and your nomination form must bear the same signature.

Please select the following documents in PDF OR JPG format.

Client Passport Please

Drag and drop files here or click to upload

Required

Maximum Allowed Upload Size Is: 4MB

Please note to process your application your passport(s) MUST have a Holder's Draw matching the signature on this form.

Signature Adult Student / Parent / Legal Guardian Signature and Declaration

अस्वीकरण:
हम आधिकारिक शिक्षा प्रदाता नहीं हैं। स्वतंत्र शिक्षा एजेंटों के रूप में, हम पूछताछ में सहायता करते हैं और शिक्षा के अवसरों के संबंध में मार्गदर्शन प्रदान करते हैं। हमारे नेटवर्क के कुछ एजेंट विशिष्ट शिक्षा प्रदाताओं के साथ औपचारिक साझेदारी कर सकते हैं और सीधे उनका प्रतिनिधित्व कर सकते हैं। हालाँकि, कोई भी अंतिम निर्णय, प्रस्ताव या समझौता केवल संबंधित शिक्षा प्रदाता द्वारा किया जाता है। साझा की गई सभी जानकारी केवल सलाहकारी उद्देश्यों के लिए है।/पी>

अधिक जानकारी के लिए अनुरोध

सिडनी विश्वविद्यालय

CRICOS CODE 00026A

संस्था का शीर्षक:

सिडनी विश्वविद्यालय
The University of Sydney

के रूप में भी व्यापार कर रहे हैं:

सिडनी विश्वविद्यालय
The University of Sydney

इंस्टीट्यूशन क्रिकोस कोड:

00026A

संस्था का प्रकार:

सरकार

जगह:

न्यू साउथ वेल्स 2006

वेबसाइट:

https://sydney.edu.au

छात्रों की कुल संख्या:

44600

कैमडेन कैम्पस

मैलेट स्ट्रीट कैम्पस

सिडनी कॉलेज ऑफ आर्ट्स

सिडनी मेडिकल स्कूल परिसर और शिक्षण अस्पताल

सर्री हिल्स कैम्पस

133 कैसलरेघ स्ट्रीट, सीबीडी

सिडनी कंज़र्वेटोरियम ऑफ़ म्यूज़िक

वेस्टमीड

वन ट्री आइलैंड रिसर्च स्टेशन

Genuine Student (GS) Declarations

AGENT DETAILS

Agent Authorization

This Page In Other Language

इस पृष्ठ को अपने नेटवर्क के साथ साझा करें

अधिक जानकारी के लिए अनुरोध

सिडनी विश्वविद्यालय

CRICOS CODE 00026A

संस्था का शीर्षक: सिडनी विश्वविद्यालयThe University of Sydney

के रूप में भी व्यापार कर रहे हैं: सिडनी विश्वविद्यालयThe University of Sydney

इंस्टीट्यूशन क्रिकोस कोड: 00026A

संस्था का प्रकार: सरकार

जगह: न्यू साउथ वेल्स 2006

वेबसाइट: https://sydney.edu.au

छात्रों की कुल संख्या: 44600

कैमडेन कैम्पस

मैलेट स्ट्रीट कैम्पस

सिडनी कॉलेज ऑफ आर्ट्स

सिडनी मेडिकल स्कूल परिसर और शिक्षण अस्पताल

सर्री हिल्स कैम्पस

133 कैसलरेघ स्ट्रीट, सीबीडी

सिडनी कंज़र्वेटोरियम ऑफ़ म्यूज़िक

वेस्टमीड

वन ट्री आइलैंड रिसर्च स्टेशन

Agent Nomination Form

Genuine Student (GS) Declarations

AGENT DETAILS

Agent Authorization

This Page In Other Language

इस पृष्ठ को अपने नेटवर्क के साथ साझा करें

संस्था का शीर्षक:

सिडनी विश्वविद्यालय
The University of Sydney

के रूप में भी व्यापार कर रहे हैं:

सिडनी विश्वविद्यालय
The University of Sydney

इंस्टीट्यूशन क्रिकोस कोड:

00026A

संस्था का प्रकार:

सरकार

जगह:

न्यू साउथ वेल्स 2006

वेबसाइट:

https://sydney.edu.au

छात्रों की कुल संख्या:

44600